Importance of Evaluating the Outer Lips for Actinic Keratosis: A.K.A Actinic Cheilosis, Solar Keratosis of the lips, Farmer’s Lip and Sailor’s Lip. Potentially unremarkable lesions with consequences.

Have you ever noticed little scaly plaques on someone’s face, neck, top of their head, or lips? Commonly mistaken for chapped lips, Actinic Cheilosis are 1-2 millimeter or larger plaques on the outer surface of the lips. Usually grey-brown in color and scaly around the borders of the lesion, there can also be a blurring of the vermilion border of the lip.

Actinic Keratoses are Premalignant lesions that can transform into Squamous Cell Carcinoma

Risk Factors for Actinic Cheilosis and Keratosis include: Older age, usually greater than 40-45. Living and working in a Higher UV indexed location for prolonged periods of time. Red/Blonde hair with fairer skin. History of Skin Cancer. Outdoor occupations with long exposures to sun. Immune Deficiencies. There is also an increase in risk when a larger number of lesions are noted, long-standing lesions, or lesions on individuals who are not protecting themselves from the elements.

Diagnosis involves ideally catching the lesions early, then biopsy to be sent to lab to determine histology and diagnose. There is a 2.5x increase in malignant transformation in these lesions, but the onset can take years.

Treatment can involve Excision, cryotherapy, or topical drug therapy depending on stage caught.

Preventive Measures: Limit your UV exposure as much as possible — Hats that cover surface of lips and face. Wear SPF 30 broad spectrum sunscreen. Lip Balm with SPF with frequent reapplications. Limit sun time¹.

Be on the lookout for suspicious lesions and feel free to contact a Dermatologist if questions arise

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1. Neville, B. W., Damm, D. D., Allen, C. M., & Chi, A. C. (2016). Oral and maxillofacial pathology. Elsevier. 

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